TY - JOUR
T1 - Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity
AU - Galioto, Rachel
AU - O’Leary, Kevin C.
AU - Thomas, J. Graham
AU - Demos, Kathryn
AU - Lipton, Richard B.
AU - Gunstad, John
AU - Pavlović, Jelena M.
AU - Roth, Julie
AU - Rathier, Lucille
AU - Bond, Dale S.
N1 - Funding Information:
Dale S. Bond, PhD – received research support from the NIH/NINDS, R01 NS077925 (Principle Investigator); and travel/conference registration support from The American Headache Society. Jelena Pavlovic, MD, PhD – received consulting honoraria from Allergan, Inc. Richard B. Lipton, MD – received research support from the NIH PO1 AG003949 (Program Director), RO1 AG038651-01A1 (PI, Einstein), U10 NS077308-01 (PI), RO1 NS07792503 (Investigator), RO1 AG042595-01A1 (Investigator), RO1 NS08243203 (Investigator), K23 NS096107-01 (Mentor), the National Headache Foundation and Boston Scientific; serves on the editorial boards of Neurology and as senior advisor to Headache. He has reviewed for the NIA and NINDS, holds stock options in eNeura Therapeutics; serves as consultant, advisory board member, or has received honoraria from: Alder, Allergan, American Headache Society, Amgen, Autonomic Technologies, Avanir, Boehringer-Ingelheim, Boston Scientific, Bristol-Myers Squibb, Colucid, Dr. Reddy’s, Electrocore, Eli Lilly, eNeura Therapeutics, Merck, Novartis, Pfizer, Teva, Vedanta. He receives royalties from Wolff’s Headache, 8th Edition, Oxford Press University, 2009 and Informa. The authors declare that they have no competing interests.
Funding Information:
This work was supported by the National Institute of Neurological Disorders and Stroke [grant number NS077925].
Publisher Copyright:
© 2017, The Author(s).
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background: Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. Methods: Women (n = 105) aged 18–50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. Results: Participants on average had BMI of 35.1 ± 6.5 kg/m2and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β =.241, SE =.14, p =.03) and magnification subscale (β =.311, SE =.51, p <.01) scores were significant independent correlates of longer attack duration. IC interacted with total PCS (β = 1.106, SE =.001, p =.03) rumination (β = 1.098, SE =.001, p =.04), and helplessness (β = 1.026, SE =.001, p =.04) subscale scores to predict headache pain intensity, such that the association between PC and pain intensity became more positive at lower levels of IC. Conclusions: Results showed that lower IC interacted with higher PC, both overall and specific subcomponents, to predict higher pain intensity during migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.
AB - Background: Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. Methods: Women (n = 105) aged 18–50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. Results: Participants on average had BMI of 35.1 ± 6.5 kg/m2and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β =.241, SE =.14, p =.03) and magnification subscale (β =.311, SE =.51, p <.01) scores were significant independent correlates of longer attack duration. IC interacted with total PCS (β = 1.106, SE =.001, p =.03) rumination (β = 1.098, SE =.001, p =.04), and helplessness (β = 1.026, SE =.001, p =.04) subscale scores to predict headache pain intensity, such that the association between PC and pain intensity became more positive at lower levels of IC. Conclusions: Results showed that lower IC interacted with higher PC, both overall and specific subcomponents, to predict higher pain intensity during migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.
KW - Inhibitory control
KW - Migraine
KW - Obesity
KW - Overweight
KW - Pain catastrophizing
UR - http://www.scopus.com/inward/record.url?scp=85016728930&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016728930&partnerID=8YFLogxK
U2 - 10.1186/s10194-017-0748-8
DO - 10.1186/s10194-017-0748-8
M3 - Article
C2 - 28357702
AN - SCOPUS:85016728930
SN - 1129-2369
VL - 18
JO - The journal of headache and pain
JF - The journal of headache and pain
IS - 1
M1 - 41
ER -
